The incidence of diabetes continues to increase dramatically; this incidence is predominantly of the type‐2 form which clusters together with other comorbidities of hypertension and lipid abnormalities, to form the metabolic syndrome. These conditions will have an increasing impact on urological practice, with erectile dysfunction, hypogonadism, voiding difficulties and urinary tract infections all more common in these patients. These symptoms might be the initial presentation of previously undiagnosed diabetes and it is important to recognise this condition early to avoid later complications including end‐stage renal failure.
RESULTSThe period 1984-2002 was divided into three intervals, i.e. 1984-95, 1996-98 and 1999-2002. The mean testicular tumour size in the three intervals decreased from 4 cm (162 tumours) to 3.2 cm (85) and 2.5 cm (72; P = 0.002, Student's t -test). The proportion of tumours of < 2 cm on presentation also increased, from 11% to 14% and 23% in the three intervals, respectively, while the proportion of patients with stage 1 disease increased from 57%, to 63% and 77%, respectively.
CONCLUSIONSThe size of testicular tumours on presentation has shown a consistent decline in the last two decades, the mean size now being 2.5 cm. That 23% are now < 2 cm raises the possibility of testis-preserving surgery in this young group of patients, who have an excellent prognosis, and therefore in the long-term issues such as psychological morbidity and natural fertility assume greater importance. There is a need for a randomized controlled trial to evaluate these issues.
Knotting of feeding tubes or urinary catheters has been reported as a rare complication in paediatrics when draining the bladder. This is caused by inserting thin flexible tubes too far in, allowing it to coil. We present a case of a 70-year-old woman who was catheterised during a routine spinal surgery, and the catheter coiled and balloon failed to deflate requiring a cystostopic approach to puncture the balloon and remove it. Awareness of this complication in female catheterisation and education on length of catheter insertion is important to avoid this.
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